Imfinzi (durvalumab) vs Cosela (trilaciclib)

Imfinzi (durvalumab) vs Cosela (trilaciclib)

Imfinzi (durvalumab) is an immune checkpoint inhibitor used primarily to treat certain types of lung cancer and bladder cancer by helping the immune system to detect and attack cancer cells. Cosela (trilaciclib), on the other hand, is a cyclin-dependent kinase inhibitor designed to protect bone marrow cells from damage caused by chemotherapy in patients with extensive-stage small cell lung cancer. When deciding between the two, it is important to consider the type of cancer being treated and the goal of therapy, as Imfinzi is used as a direct cancer treatment, while Cosela is used to mitigate the side effects of chemotherapy, not as a cancer treatment itself.

Difference between Imfinzi and Cosela

Metric Imfinzi (durvalumab) Cosela (trilaciclib)
Generic name Durvalumab Trilaciclib
Indications Urothelial carcinoma, non-small cell lung cancer (NSCLC), extensive-stage small cell lung cancer (ES-SCLC) Decrease incidence of chemotherapy-induced myelosuppression
Mechanism of action Programmed death-ligand 1 (PD-L1) blocking antibody Cyclin-dependent kinase 4/6 (CDK4/6) inhibitor
Brand names Imfinzi Cosela
Administrative route Intravenous infusion Intravenous infusion
Side effects Fatigue, musculoskeletal pain, constipation, decreased appetite, nausea, peripheral edema, urinary tract infection, fever, rash, dyspnea Fatigue, hypocalcemia, hypokalemia, hypophosphatemia, increased aspartate aminotransferase, headache, pneumonia
Contraindications None known None known
Drug class Anti-PD-L1 monoclonal antibody CDK4/6 inhibitor
Manufacturer AstraZeneca G1 Therapeutics, Inc.

Efficacy

Imfinzi (Durvalumab) Efficacy in Lung Cancer

Imfinzi (durvalumab) is a monoclonal antibody classified as an immune checkpoint inhibitor, specifically targeting the PD-L1 protein. It has been approved for use in certain types of lung cancer, including unresectable, Stage III non-small cell lung cancer (NSCLC) after chemoradiation therapy, and extensive-stage small cell lung cancer (SCLC) as part of a combination therapy. In the context of Stage III NSCLC, clinical trials have demonstrated that Imfinzi can significantly improve progression-free survival (PFS) when compared to placebo. The PACIFIC trial, a pivotal study for this indication, showed a median PFS of 16.8 months for patients treated with durvalumab versus 5.6 months for the placebo group, marking a substantial improvement in delaying disease progression.

Furthermore, Imfinzi has shown an increase in overall survival (OS) in patients with unresectable Stage III NSCLC. The PACIFIC trial reported a 32% reduction in the risk of death compared to placebo, with a median OS not reached for the durvalumab group at the time of the interim analysis, versus 28.7 months for the placebo group. These results underscore the potential of Imfinzi to provide a survival benefit for patients with this type of lung cancer.

Cosela (Trilaciclib) Efficacy in Lung Cancer

Cosela (trilaciclib) is a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor that is used to decrease the incidence of chemotherapy-induced myelosuppression in adult patients when administered prior to a platinum/etoposide-containing regimen or topotecan-containing regimen for extensive-stage small cell lung cancer (ES-SCLC). Trilaciclib is designed to protect bone marrow function during chemotherapy by transiently arresting hematopoietic stem and progenitor cells in the G1 phase of the cell cycle. Clinical trials have demonstrated that Cosela can significantly reduce the occurrence of severe neutropenia, a common and serious side effect of chemotherapy that can lead to dose delays and reductions, as well as life-threatening infections.

In a randomized, double-blind, placebo-controlled study, patients with ES-SCLC who received trilaciclib before their chemotherapy regimen showed a higher overall survival rate compared to those who received a placebo. The study reported that the median OS was 12.8 months for the trilaciclib group compared to 10.9 months for the placebo group. While the primary endpoint of these studies was to assess the impact on myelosuppression, the observed improvement in overall survival suggests an additional potential benefit of trilaciclib in the treatment of ES-SCLC when used in conjunction with chemotherapy.

Regulatory Agency Approvals

Imfinzi
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Health Canada
  • Therapeutic Goods Administration (TGA), Australia
  • Medsafe (NZ)
Cosela
  • Food and Drug Administration (FDA), USA

Access Imfinzi or Cosela today

If Imfinzi or Cosela are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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